原发性肝癌患者调节性T细胞与预后的关系  

The Correlation of Reguolarory T Cells in Hepatocellular Carcinoma Patients with Prognosis: A Report of 138 Cases

作　　者：樊永丽[1] 于津浦[1] 李慧[1] 曹水[1] 任宝柱[1] 张乃宁[1] 于文文[1] 任秀宝[1] 

机构地区：[1]天津市肿瘤防治重点实验室,天津市肿瘤研究所免疫实验室,天津医科大学附属肿瘤医院生物治疗科,天津市300060

出　　处：《中国肿瘤临床》2011年第8期442-446,共5页Chinese Journal of Clinical Oncology

基　　金：天津市科技创新专项基金(编号:06FZZDSF01500);天津市应用基础及前沿技术研究计划(编号:09JCZDJC20400)资助~~

摘　　要：目的探讨肝细胞肝癌(HCC)患者T淋巴细胞亚群对其预后的影响。方法:对138例HCC患者的临床病理资料进行回顾性分析,采用流式细胞技术(FCM)检测早晚期HCC患者外周血T淋巴细胞不同分群占外周血单个核细胞(PBMC)的比例,Kaplan-Meier法检验T淋巴细胞亚群对HCC患者生存的影响。结果:138例HCC患者的1年生存率为61%,2年生存率为39%,早晚期HCC患者的中位生存时间分别为28、12个月。晚期HCC患者的CD4^+T细胞比例低于早期患者,调节性T细胞(Treg)与NK细胞比例高于早期患者,并且差异均有统计学意义(P<0.05)。单因素分析显示T淋巴细胞亚群中Treg是影响HCC患者预后的相关因素。在进一步分析影响Treg的因素时发现有肝硬化的HCC患者外周血Treg比例及绝对数高于无肝硬化的HCC患者(P=0.029),铁蛋白(Ferr)正常的HCC患者外周Treg绝对数高于Ferr水平高的HCC患者(P=0.027)。结论:HCC患者的Treg在一定程度上影响其预后,Treg比例>7%是影响晚期肝硬化HCC患者预后的独立危险因素。Objective： To evaluate the relationship of lymphocyte subsets in hepatocellular carcinoma （ HCC ） patients with prognosis. Methods： Data of 138 HCC patients were retrospectively analyzed. Flow cytometry was used to analyze the changes in several subsets of lymphocyte in the peripheral blood of HCC patients of early and advanced stages. The influence of subsets of lymphoeytes on prognosis of HCC was analyzed. Results： The survival time ranged 1-34.5 months and the overall 1- and 2-year survival rates were 61% and 39%, respectively. The median survival time of early and advanced stage disease was 28 and 12 months. The percentage of CD4＋ T cells of advanced stage HCC patients was lower than that of early stage HCC （ P 〈 0.05 ）. The percentages of Treg and NK cells of advanced stage HCC patients were lower than those of early stage HCC patients （ P 〈 0.05 ）. Univariate analysis showed that Treg was the only influential factor for the overall survival of HCC patients. The percentage of Treg cells in peripheral blood of HCC patients with cirrhosis was higher than that in peripheral blood of HCC patients without cirrhosis （ P = 0.029 ）. The percentage of Treg cells in HCC patients with normal ferritin level was higher than in HCC patients with higher ferritin level （ P = 0.027 ）. Conclusion： To some extent, the immune function of HCC patients is associated with their prognosis. The percentage of Treg is an independent prognostic factor for advanced stare HCC patients with cirrhosis.

关 键 词：肝细胞肝癌 免疫功能 T细胞亚群 调节性T细胞 预后 

分 类 号：R735.7[医药卫生—肿瘤]